Provider Demographics
NPI:1285916684
Name:ESTHER OLITA LAYTON MD PA INC
Entity type:Organization
Organization Name:ESTHER OLITA LAYTON MD PA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:OLITA
Authorized Official - Last Name:LAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-434-3025
Mailing Address - Street 1:PO BOX 27
Mailing Address - Street 2:
Mailing Address - City:SELMER
Mailing Address - State:TN
Mailing Address - Zip Code:38375-0027
Mailing Address - Country:US
Mailing Address - Phone:731-434-3025
Mailing Address - Fax:731-434-3027
Practice Address - Street 1:11300 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-7451
Practice Address - Country:US
Practice Address - Phone:731-434-3025
Practice Address - Fax:731-434-3027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92325207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID